Interprofessional Genetic Cancer Prevention Clinic Centralizes Care for Patients and Providers
By coordinating and implementing cancer risk reduction strategies, promoting cascade testing, and promoting genetics-related cancer research, one institution’s new genetic cancer prevention clinic (GCPC) improved surveillance, additional testing, discovery of new pathogenic variants (https://www.ons.org/genomics-taxonomy/variant-subcategories#:~:text=likely%20pathogenic%20variant.-,pathogenic%20variant,-Directly%20contributes%20to), and overall patient satisfaction, a team of oncology nurses and other healthcare professionals reported during a poster presentation (https://ons.confex.com/ons/2024/meetingapp.cgi/Paper/14632) at the 49th annual ONS Congress® in April 2024.
“The GCPC was developed from a system-wide provider desire to deliver for a centralized clinic to deliver complex, variant-specific care and address related concerns,” the speakers said (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3795). “Patients voiced interest in a clinic construct to help with navigating a complex health system.”
The team, which included ONS members Kathryn Pratt, BSN, RN, OCN®, CBCN®, ONN-CG, and Megan Templo, BSN, RN, CNOR, CBCN®, HWNC-BC, created a weekly, interprofessional clinic for increased risk for hereditary (https://www.ons.org/genomics-taxonomy/mode-inheritance) cancers because of a known pathogenic variant (https://www.ons.org/genomics-taxonomy/variant-subcategories#:~:text=likely%20pathogenic%20variant.-,pathogenic%20variant,-Directly%20contributes%20to) but were not currently on active cancer treatment.
In the first 12 months, the GCPC served (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3795) 166 patients across four U.S. states (California, Oklahoma, New Mexico, and Texas). Of those, 115 were previvors and the remainder had histories of breast cancer (n = 27), melanoma (n = 4), ovarian cancer (n = 3), kidney cancer (n = 2), and other cancers (n = 15). A majority of patients were aged 21–50 (66%), and 4% were Asian, 6% Black, 7% Hispanic or Latino, 79% White, and 4% from other racial and ethnic groups. The most commonly reported known genetic variants were BRCA2, BRCA1 (https://voice.ons.org/news-and-views/genetic-disorder-reference-sheet-brca1-and-brca2-hereditary-cancers), CHEK2 (https://voice.ons.org/news-and-views/genetic-disorder-reference-sheet-chek2-gene-pathogenic-variants), PALB2 (https://voice.ons.org/news-and-views/genetic-disorder-reference-sheet-palb2), and ATM (https://voice.ons.org/news-and-views/genetic-disorder-reference-sheet-atm-pathogenic-variants).
The GCPC’s services (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3795) are twofold:
- Education (e.g., National Comprehensive Cancer Network recommendations, clinical trial opportunities, support services, cascade testing (https://voice.ons.org/news-and-views/an-oncology-nurses-guide-to-cascade-testing), healthy lifestyle behaviors)
- Referrals (e.g., laboratory tests, screening tests, primary care, specialty care such as dermatology or gynecologic and breast oncology consults)
After participating in the GCPC and its services, 100% of patients said (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3795) they “definitely felt empowered” to make healthcare decisions about their cancer risk and 92% said they were “confident discussing results with family members.”
“When you are first diagnosed, your head goes to terrible places,” one patient reported (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3795). “Once someone framed it in a different light, I took back the power.”
Get oncology nursing guides to the most common genetic disorders (https://voice.ons.org/search/node?keys=genetic%20disorder%20reference%20sheet) associated with a higher risk for cancer, and learn more about hereditary cancer genetics by listening to the Oncology Nursing Podcast Episode 56 (https://www.ons.org/podcasts/episode-56-hereditary-cancer-genetics-ons-congress) on your favorite podcast platform or by using the player below. Then, use ONS’s Is My Cancer Hereditary? discussion tool (https://www.ons.org/clinical-practice-resources/my-cancer-hereditary-discussion-tool) to talk to your patients about hereditary cancer risks, red flags, and referrals to genetics professionals.